• Journal of the Korean Orthopaedic Association
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• v.56 no.2
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• pp.183-189
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• 2021

Arthrodesis is one of the last options available to obtain a stable, painless knee in patients who are unable to undergo reconstructive surgery due to a damaged knee joint. A variety of techniques have been used, including external fixation, internal fixation by compression plates, intramedullary fixation through the knee with a modular nail, and antegrade nailing through the piriformis fossa. Another option is the use of a short nail such as the Neff nail, the Wichita nail, or the Huckstep nail, but there are no commercial short nails available for use in Korea. This technical report describes a technique for knee arthrodesis using a retrograde femoral intramedullary nail.

• KSCE Journal of Civil and Environmental Engineering Research
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• v.28 no.6C
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• pp.331-338
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• 2008

Soil nailing is used as a method of slope stabilization and excavation support. The design method of soil nail are based on experience or assumption of interaction between soil and reinforcement. Most design methods simply considers the tension of reinforcement for analysis of slope stabilization. Soil nails interact with soils under combined loading of shear and tension. Jewell & Pedley suggested a design equation of shear force with bending stiffness and discussed that the magnitude of the maximum shear force is small in comparison with the maximum axal force. However, they have used a very conservative limiting bearing stress on nails. This paper discusses that the shear strength of soil nails should not be disregarded with proper bearing stresses on nails. The modified FHWA design method was proposed by considering shear forces on nails with bending stiffness.

• Hip & pelvis
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• v.35 no.3
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• pp.175-182
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• 2023

Purpose: This study aims to compare patients in whom fixation failure occurred via cut-out (CO) or cut-through (CT) in order to determine patient factors and radiographic parameters that may be predictive of each mechanism. Materials and Methods: This retrospective cohort study includes 18 patients with intertrochanteric (IT) hip fractures (AO/OTA classification 31A1.3) who underwent treatment using a single lag screw design intramedullary nail in whom fixation failure occurred within one year. All patients were reviewed for demographics and radiographic parameters including tip-to-apex distance (TAD), posteromedial calcar continuity, neck-shaft angle, lateral wall thickness, and others. Patients were grouped into cohorts based on the mechanism of failure, either lag screw CO or CT, and a comparison was performed. Results: No differences in demographics, injury details, fracture classifications, or radiographic parameters were observed between CO/CT cohorts. Of note, a similar rate of post-reduction TAD>25 mm (P=0.936) was observed between groups. A higher rate of DEXA (dual energy X-ray absorptiometry) confirmed osteoporosis (25.0% vs. 60.0%) was observed in the CT group, but without significance. Conclusion: The mechanism of CT failure during intramedullary nail fixation of an IT fracture did not show an association with clinical data including patient demographics, reduction accuracy, or radiographic parameters. As reported in previous biomechanical studies, the main predictive factor for patients in whom early failure might occur via the CT effect mechanism may be related to bone quality; however, conduct of larger studies will be required in order to determine whether there is a difference in bone quality.

• Journal of the Korean Orthopaedic Association
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• v.52 no.1
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• pp.25-32
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• 2017

Purpose: The purpose of this study was to analyze the radiological and clinical outcomes in elderly patients with unstable intertrochanteric femur fractures in accordance with the length of intramedullary nail. Materials and Methods: Between August 2009 and December 2014, a total of 139 patients-older than 65 years of age with AO/OTA classification of 31-A2 unstable intertrochanteric femur fracture-who has been followed-up for at least 1 year after the treatment with internal fixation by using an intramedullary nail were enrolled for this retrospective control study. The subjects were classified into two groups according to the length of intramedullary nail: 106 patients in the short group (group I) and 33 patients in the long group (group II). For radiological assessments, the reduction state, time to union, and implant related complications were examined. The clinical outcomes were assessed by preoperative hemoglobin, operating time, intraoperative bleeding amount, blood transfusion rate, hospitalization period, and Charnley hip pain scoring system at the final follow-up. Results: The postoperative radiographs showed good or acceptable reduction in all cases. The mean time of radiologic bone union was 4.8 months, and there was no difference between the two groups. With respect to surgical time, the group II was found to take longer (57.87 minutes) than the group I (45.65 minutes) (p=0.003). The bleeding amount during surgery of the group II was greater (288.78 ml) than that of the group I (209.90 ml) (p=0.046). The clinical results at the final follow-up were found to be satisfactory in both groups. Conclusion: In cases of good reduction of the fracture from the treatment of unstable intertrochanteric femur fracture accompanying the posteromedial fragment in elderly patients, both groups-long and short intramedullary nails-showed satisfactory radiological and clinical outcomes.

• Journal of the Korean Geotechnical Society
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• v.15 no.6
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• pp.71-86
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• 1999

The displacements of soil nailed wall and the nail tensile force for 11 soil nailing sites were investigated by using measurements obtained from inclinometer and strain gauge. The maximum horizontal displacement which occurred between 5% and 15% of the final excavation depth was found to be below 0.3% and 0.2% of excavation depth for well and poorly constructed sites. It was also found that the maximum horizontal displacements for 0.4%, 0.3% and 0.2% of excavation depth occurred when the ratios of nail length to final excavation depth were 0.5, 0.5~0.6 and 0.6~0.7. But the maximum horizontal displacement increased by 0.3% of excavation depth when the ratio was above 0.7. This was probably due to the shallow excavation depth and the deep soil stratum. The non-dimensional maximum tensile force of nail, K, from ground surface to $(0.6H_f)$ of the final excavation depth was less than 0.8 and decreased linearly between $(0.6H_f)$ and the final excavation depth. Also, the maximum tensile force was found to reach up to 60% of the ultimate tensile force at final excavation.

• The Journal of the Korean bone and joint tumor society
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• v.11 no.2
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• pp.111-117
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• 2005

Purpose: We evaluate the results of treatment of pathologic femur fractures secondary to bone tumors in children. Materials and Methods: Between January 1995 and June 2004, 18 patients(20 cases) were evaluated. Their mean age of the first episode of fracture was 10.2 years and mean follow-up period is 42.5 months. Primary bone tumors, the location of fracture, time to union and complications were evauated. Results: Fractures occurred at proximal portion in 14 cases, shaft 3 cases and distal portion 3 cases. The bone tumors causing pathologic fracture were fibrous dysplasia(9 c ases), simple bone cyst(4 cases), aneurysmal bone cyst(4 cases), nonossifying fibroma(2 cases) and eosinophilic granuloma(1 case). In the treatment for fractures, cast was in 11 cases, internal fixation 8 cases and external fixation in 1 case. In the treatment for tumors, observation was in 11 cases, curettage & bone graft in 8 cases and resection in 1 case. In polyostotic fibrous dysplasia, all cases were treated by cast initially but deformity developed in all cases. Fracture prevention and deformity correction were obtained with intramedullary nailing. Conclusion: Adequate choice of treatment of bone tumor and fracture will result in good prognosis.

• The Journal of Engineering Geology
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• v.19 no.2
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• pp.191-203
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• 2009

The effect of stabilizing piles on cut slopes is checked and the behavior of slope soil and piles are observed throughout the year by field measurements on the large-scale cut slopes. First of all, the behavior of the slope soil was measured by inclinometers during slope modification. Landslides occurred in this area due to the soil cutting for slope modification. The horizontal deformations of slope soil are gradually increased and rapidly decreased at depth of sliding surface. As the result of measuring deformation, the depth of sliding surface below the ground surface can be known. Based on the measuring the depth of the sliding surface, some earth retention system including stabilizing piles were designed and constructed in this slope. To check the stability of the reinforced slope using stabilizing piles, an instrumentation system was installed. As the result of instrumentation, the maximum deflection of piles is measured at the pile head. It is noted that the piles deform like deflection on a cantilever beam. The maximum bending stress of piles is measured at the soil layer. The pile above the soil layer is subjected to lateral earth pressure due to driving force of the slope, while pile below soil layer is subjected to subgrade reaction against pile deflection. The deflection of piles is increased during cutting slope in front of piles for the construction of soil nailing. As a result of research, the effect and applicability of stabilizing piles in large-scale cut slopes could be confirmed sufficiently.

• Journal of the Korean Geotechnical Society
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• v.29 no.1
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• pp.49-59
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• 2013

Heavy rainfall intensity may cause shallow slope failures and debris flow by rill erosion and scour on land surface. The paper represents the difference between native soil (weathered soil) and reinforced soil, which is mixed by hardening agent with flyash as main material, for investigating experimental findings of rill erosion and erosion. Results obtained from artificial rainfall simulator show that erosion rate of reinforced soil mixed with hardening agent is reduced by 20% because an amount of eroded soil on slope surface is inversely proportional to the increase of soil strength. For example, rainfall of 45mm (at the elapsed time of 25mins in rainfall intensity of 110mm/hr) triggers rill erosion on native soil surface, but the rill erosion on reinforced soil surface does not even occur at 330mm rainfall (at the elapsed time of 3hrs in rainfall intensity of 110mm/hr). As a result of slope stability analysis, it was found that the construction method for reinforced soil surface would be more economical, easy and fast construction technology than conventional reinforcement method.

• Journal of the Korean Geotechnical Society
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• v.15 no.3
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• pp.41-70
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• 1999

The benefits of utilizing internal reinforced members, such as soil nails and ground anchors, in maintaining stable excavations and slopes have been known among geotechnical engineers to be very effective. Occasionally, however, both soil nails and ground anchors are simultaneously used in one excavation site. In the present study, a method of limit equilibrium stability analysis of the excavation zone reinforced with the vertically or horizontally mixed nail-anchor system is proposed to evaluate the global safety factor with respect to a sliding failure. The postulated failure wedges are determined based on the results of the $FLAC^{2D}\; 및\; FLAC^{3D}$ program analyses. This study also deals with a determination of the required thickness of the shotcrete facing. An excessive facing thickness may be required due to both the stress concentration and the relative displacement at the interface zone between the soil nailing system and the ground anchor system. A simple finite element method of analysis is presented to estimate the corresponding relative displacement at the interface zone between two different support systems. As an efficient resolution to reduce the facing thickness, the modified bearing plate system is also proposed. Finally with various analysis related to the effects of design parameters, the predicted displacements are compared with the results of the $FLAC^{2D}$ program analyses.

• Journal of the Korean GEO-environmental Society
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• v.15 no.2
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• pp.5-15
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• 2014

Target reliability index in the limit state design indicated the safety margin and it is important to determine the partial factor. To determine the target reliability index which is needed in the limit state design, the six design and construction case histories of gravel compaction piles (GCP) were investigated. The limit state functions were defined by bulging failure for the major failure mode of GCP. The reliability analysis were performed using the first order reliability method (FORM) and the reliability index was calculated for each ultimate bearing capacity formulation. The reliability index of GCP tended to be penportional to the safety factor of allowable stress design and average value was ${\beta}$=2.30. Reliability level that was assessed by reliability analysis and target reliability index for existing structure foundations were compared and analyzed. As a result, The GCP was required a relatively low level of safety compared with deep and shallow foundations and the currd t reliability level were similar to the target reliability in the reinforced earth retaining-wall and soil-nailing. Therefore the target reliability index of GCP suggested as ${\beta}_T$=2.33 by various literatures together with the computed reliability level in this study.